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Clinical efficacy of psoralen + sunlight vs. combination of isotretinoin and psoralen + sunlight for the treatment of chronic plaque‐type psoriasis vulgaris: a randomized hospital‐based study
Author(s) -
Gahalaut Pratik,
Soodan Puneet Singh,
Mishra Nitin,
Rastogi Madhur Kant,
Soodan Hardev Singh,
Chauhan Sandhya
Publication year - 2014
Publication title -
photodermatology, photoimmunology and photomedicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.736
H-Index - 60
eISSN - 1600-0781
pISSN - 0905-4383
DOI - 10.1111/phpp.12125
Subject(s) - medicine , psoriasis , psoriasis area and severity index , psoralen , isotretinoin , dermatology , sunlight , randomized controlled trial , puva therapy , plaque psoriasis , acne , dna , genetics , physics , astronomy , biology
Summary Background Isotretinoin has been used in combination with oral psoralen + UVA ( PUVA ) and narrowband UVB ( NBUVB ) for treating psoriasis, especially in women of child‐bearing age. The efficacy of oral psoralen + sun exposure ( PUVA sol) is comparable to that of PUVA . This study was planned to compare the efficacy of oral PUVA sol with that of the combination of oral isotretinoin and PUVA sol in patients with chronic plaque psoriasis. Methods Forty patients with psoriasis vulgaris were randomized to two groups. Group A (control group) received PUVA sol only. Group B (intervention group) received PUVA sol + isotretinoin (0.5 mg/kg/day). P soriasis A rea S everity I ndex ( PASI ) score was recorded at baseline and weeks 4, 8 and 12. Dermatology Life Quality Index was assessed at baseline and 12 weeks. The end point of the study was PASI 75 or 12 weeks, whichever came earlier. Results Thirty‐five patients completed the study. There were statistically significant differences between the two study groups for the number of patients achieving the endpoint of PASI 75, PASI scores at the end of 12 weeks, mean duration to achieve PASI 75, number of PUVA sol sessions needed to achieve PASI 75 and mean cumulative dosage of 8‐methoxypsoralen needed to achieve PASI 75. Conclusion The combination of isotretinoin with PUVA sol is more effective compared with PUVA sol alone for treating chronic plaque psoriasis.